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| | pronounce = | | | pronounce = |
| | field = [[Dermatology]] | | | field = [[Dermatology]] |
| | symptoms = | | | symptoms = [[Itchy]] [[hives]], [[swelling]] of hands, feet, or face, [[angioedema]], [[wheezing]] |
| | complications = | | | complications = [[Anaphylaxis]], [[pharyngeal edema]], [[drowning]], [[hypothermia]] |
| | onset = | | | onset = Usually in [[childhood]] or [[early adulthood]] |
| | duration = | | | duration = Variable; may last months to years |
| | types = | | | types = Primary, secondary, reflex, familial |
| | causes = Exposure to cold stimulus | | | causes = Exposure to [[cold stimulus]] (air, water, food, objects) |
| | risks = | | | risks = [[Swimming]], cold climates, ingestion of cold [[food]] or [[beverages]] |
| | diagnosis = | | | diagnosis = [[Cold stimulation test]], [[clinical evaluation]] |
| | differential = | | | differential = [[Cholinergic urticaria]], [[aquagenic urticaria]], [[cryoglobulinemia]] |
| | prevention = | | | prevention = Avoidance of cold exposure, protective clothing |
| | treatment = | | | treatment = [[Antihistamines]], [[epinephrine]] (for anaphylaxis), [[immunosuppressants]] (severe cases) |
| | medication = | | | medication = [[Cetirizine]], [[loratadine]], [[hydroxyzine]] |
| | prognosis = | | | prognosis = Often improves with age, but may persist |
| | frequency = | | | frequency = Rare |
| | deaths = | | | deaths = Rare; associated with anaphylactic reactions |
| }} | | }} |
| '''Cold urticaria''' (essentially meaning '''cold hives''') is a disorder where hives ([[urticaria]]) or large red welts form on the skin after exposure to a cold stimulus.<ref>{{cite journal |last=Feinberg |first=Jeff H. |first2=Charles B. |last2=Toner |title=Successful Treatment of Disabling Cholinergic Urticaria |journal=Military Medicine |volume=173 |issue=2 |year=2008 |pages=217–20 |doi=10.7205/MILMED.173.2.217 |doi-access=free }}</ref> The welts are usually itchy and often the hands and feet will become itchy and swollen as well. Hives vary in size from about 7mm in diameter to as big as about 27mm diameter or larger. This disorder, or perhaps two disorders with the same clinical manifestations, can be inherited (familial cold urticaria) or acquired (primary acquired cold urticaria). The acquired form is most likely to occur between ages 18–25, although it can occur as early as 5 years old in some cases. Life-threatening risks include suffocation resulting from pharyngeal angioedema induced by cold foods or beverages, drowning after shock from swimming in cold water and anaphylactic shock.<ref name="pmid17355280">{{cite journal |author=Siebenhaar F, Weller K, : clinical picture and update on diagnosis and treatment |title=Acquired cold urticaria: Clinical picture and update on diagnosis and treatment |journal=Clin. Exp. Dermatol. |volume=32 |issue=3 |pages=241–5 |date=May 2007 |pmid=17355280 |doi=10.1111/j.1365-2230.2007.02376.x }}</ref>
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| == Types ==
| | [[File:Cold allergy symptoms.jpg|thumb|Hives on the back from exposure to cold air on an individual with cold allergy. The hives were induced by riding a stationary bike shirtless for an hour next to a door cracked open on a cool day. The temperature of the air flowing in was around 10C (50F). The lighter band at chest height was covered by a heart rate monitor strap.]] |
| Cold urticaria may be divided into the following types:<ref name="Bolognia">{{cite book |author1=Rapini, Ronald P. |author2=Bolognia, Jean L. |author3=Jorizzo, Joseph L. |title=Dermatology: 2-Volume Set |publisher=Mosby |location=St. Louis |year=2007 |pages=267–8 |isbn=978-1-4160-2999-1 |oclc= |doi= |accessdate=}}</ref> | | '''Cold urticaria''' (also known as '''cold hives''') is a rare [[allergic]] condition characterized by the development of [[hives]] or [[urticaria]] after exposure to cold temperatures. These welts are often itchy, red, and raised, and may appear on the face, hands, feet, or other areas of the body exposed to a cold stimulus. Cold urticaria can range from mild localized discomfort to systemic, life-threatening [[anaphylaxis]] in severe cases. |
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| ===Primary cold contact urticaria=== | | == Overview == |
| Primary cold contact urticaria is a cutaneous condition characterized by [[wiktionary:wheal|wheals]], and occurs in rainy, windy weather, and after swimming in cold water and after contact with cold objects, including ice cubes.<ref name="Bolognia"/>
| | Cold urticaria occurs when the body's [[immune system]] reacts abnormally to cold exposure. The release of [[histamine]] and other [[inflammatory mediators]] causes [[vasodilation]], [[capillary leakage]], and [[mast cell]] activation, resulting in redness, swelling, and itching. In some individuals, more severe symptoms such as [[angioedema]], [[low blood pressure]], or even [[anaphylactic shock]] can occur, especially with full-body cold exposure such as swimming. |
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| ===Secondary cold contact urticaria=== | | == Types == |
| Secondary cold contact urticaria is a cutaneous condition characterized by [[wiktionary:wheals|wheals]], due to serum abnormalities such as [[cryoglobulinemia]] or [[cryofibrinogenemia]] are extremely rare, and are then associated with other manifestations such as [[Raynaud's phenomenon]] or purpura.<ref name="Bolognia"/>
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| ===Reflex cold urticaria===
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| Reflex cold urticaria is a cutaneous condition in which generalized cooling of the body induces widespread [[wikt:weal|welt]]ing.<ref name="Bolognia"/>
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| ===Familial cold urticaria===
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| Familial cold urticaria (also properly known as familial cold autoinflammatory syndrome, FCAS) is an [[autosomal dominant]] condition characterized by [[rash]], [[conjunctivitis]], [[fever]]/[[chills]] and [[arthralgia]]s<ref>{{cite web|last=Tunca, Ozdogan|first=Mehmet, Huri|title=Molecular and Genetic Characteristics of Hereditary Autoinflammatory|url=http://www.benthamscience.com/cdtia/sample/cdtia4-1/0013L.pdf|publisher=Betham Science|accessdate=12 April 2011|archive-url=https://web.archive.org/web/20120318140820/http://www.benthamscience.com/cdtia/sample/cdtia4-1/0013L.pdf|archive-date=18 March 2012|url-status=dead}}</ref> elicited by exposure to cold - sometimes temperatures below 22 °C (72 °F).<ref name="Bolognia"/><ref name="Andrews">James, William; Berger, Timothy; Elston, Dirk (2005). ''Andrews' Diseases of the Skin: Clinical Dermatology''. (10th ed.). Saunders. {{ISBN|0-7216-2921-0}}.</ref>
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| It has been mapped to [[CIAS1]]<ref name="pmid11687797">{{cite journal |vauthors=Hoffman HM, Mueller JL, Broide DH, Wanderer AA, Kolodner RD |title=Mutation of a new gene encoding a putative pyrin-like protein causes familial cold autoinflammatory syndrome and Muckle-Wells syndrome |journal=Nat. Genet. |volume=29 |issue=3 |pages=301–5 |date=November 2001 |pmid=11687797 |doi=10.1038/ng756 |pmc=4322000}}</ref> and is a slightly milder member of the disease family including [[Muckle–Wells syndrome]] and [[NOMID]]. It is rare and is estimated as having a prevalence of 1 per million people and mainly affects Americans and Europeans.<ref>{{cite web|last=Home Reference|first=Genetics|title=Familial cold autoinflammatory syndrome|url=http://ghr.nlm.nih.gov/condition/familial-cold-autoinflammatory-syndrome|publisher=U.S. National Library of Medicine|accessdate=12 April 2011}}</ref>
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| FCAS is one of the [[cryopyrin-associated periodic syndrome]]s (CAPS) caused by mutations in the [[CIAS1]]/NALP3 (aka NLRP3) [[gene]] at location 1q44.<ref name="CAPS">{{cite web| last = CAPS| first = Community| title = Familial Cold Auto-inflammatory Syndrome (FCAS): Fact Sheet| publisher = Regeneron Pharmaceuticals| date = 2008-01-01| url = http://www.capscommunity.com/caps_fact_fcas_md.html| accessdate = 2010-02-01| archive-url = https://web.archive.org/web/20160304031454/http://www.capscommunity.com/caps_fact_fcas_md.html| archive-date = 2016-03-04| url-status = dead}}</ref><ref>{{cite web|last=HGNC|first=HUGO|title=Gene Name Database|url=https://www.genenames.org/cgi-bin/quick_search.pl?search=CIAS1&type=contains&num=20&submit=submit&.cgifields=type|publisher=Wellcome Foundation|access-date=2018-03-23|archive-url=https://web.archive.org/web/20121025203844/http://www.genenames.org/cgi-bin/quick_search.pl?search=CIAS1&type=contains&num=20&submit=submit&.cgifields=type|archive-date=2012-10-25|url-status=dead}}</ref><ref>{{cite web|last=Protein Data Bank (PDB)|first=RSCB|title=1q44|url=http://www.pdb.org/pdb/explore/remediatedSequence.do?structureId=1Q44|work=Crystal Structure of an Arabidopsis Thaliana Putative Steroid Sulphotransferase|publisher=RCSB|accessdate=12 April 2011}}</ref> The disease was described in [[The Lancet]] Volume 364<ref>{{cite journal|last=Hoffman |first=H.M.|url=http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(04)17401-1/abstract|journal=Lancet |title=Prevention of cold-associated acute inflammation in familial cold autoinflammatory syndrome by interleukin-1 receptor antagonist|display-authors=etal|doi=10.1016/S0140-6736(04)17401-1|pmid=15541451|volume=364|issue=9447|year=2004|pages=1779–1785|pmc=4321997}}</ref> by Hoffman H.M.<ref>{{cite web|last=Hoffman|first=Harold|title=Associate Professor of Pediatrics and Medicine, UC San Diego|url=http://raidivision.ucsd.edu/Default.aspx?tabid=65|work=The prevention of cold-associated acute inflammation in cold auto-inflammatory syndrome by interleukin-1 receptor antagonist|publisher=The Lancet vol 364|access-date=2014-02-05|archive-url=https://web.archive.org/web/20120426054728/http://raidivision.ucsd.edu/Default.aspx?tabid=65|archive-date=2012-04-26|url-status=dead}}</ref> et al.
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| The effect of FCAS on the quality of life of patients is far reaching. A survey of patients in the United States in 2008 found, "To cope with their underlying disease and to try to avoid symptomatic, painful, flares patients reported limiting their work, school, family, and social activities. Seventy-eight percent of survey participants described an impact of the disease on their work, including absenteeism and impaired job advancement; frequently, they quit their job as a consequence of their disease".<ref>{{cite journal|doi=10.1185/03007990802081543|pmid=18423104|year=2008|last1=Stych|first1=B|last2=Dobrovolny|first2=D|title=Familial cold auto-inflammatory syndrome (FCAS): characterization of symptomatology and impact on patients' lives.|volume=24|issue=6|pages=1577–82|journal=Curr Med Res Opin}}</ref>
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| Treatment using [[anakinra]] (Kineret) has been shown effective for FCAS, although this does mean daily injections of the [[immunosuppressant]] into an area such as the lower [[abdomen]].<ref name="Kineret FCAS">{{cite journal| last = Ross JB | title = Use of anakinra (Kineret) in the treatment of familial cold autoinflammatory syndrome with a 16-month follow-up| date = 2010-02-01| pmid = 18258152| last2 = Finlayson| first2 = LA| last3 = Klotz| first3 = PJ| last4 = Langley| first4 = RG| last5 = Gaudet| first5 = R| last6 = Thompson| first6 = K| last7 = Churchman| first7 = SM| last8 = McDermott| first8 = MF| last9 = Hawkins| first9 = PN| volume = 12| issue = 1| pages = 8–16| journal = Journal of Cutaneous Medicine and Surgery|display-authors=etal| doi = 10.2310/7750.2008.07050}}</ref><ref name="Kineret FCAS Rheuma">{{cite journal| last = Samy K Metyas | first = Hal M Hoffman| title = Anakinra prevents symptoms of familial cold autoinflammatory syndrome and Raynaud's disease.| journal = The Journal of Rheumatology| volume = 33| issue = 10| pages = 2085–2087| publisher = Journal of Rheumatology| date = 2008-02-01| url = http://www.jrheum.org/content/33/10/2085.abstract| accessdate =2010-02-01| pmid = 16981288}}</ref> The [[monoclonal antibody]] [[canakinumab]] (Ilaris) is also used.<ref>{{cite journal|doi=10.1358/dot.2009.45.10.1436882|pmid=20069137|year=2009|last1=Walsh|first1=GM|title=Canakinumab for the treatment of cryopyrin-associated periodic syndromes|volume=45|issue=10|pages=731–5|journal=Drugs of Today}}</ref>
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| == Signs and symptoms ==
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| [[File:Cold allergy symptoms.jpg|thumb|Hives on the back from exposure to cold air on an individual with cold allergy. The hives were induced by riding a stationary bike shirtless for an hour next to a door cracked open on a cool day. The temperature of the air flowing in was around 10C (50F). The lighter band at chest height was covered by a heart rate monitor strap.]]
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| When the body is exposed to the cold in individuals afflicted by the condition, hives appear and the skin in the affected area typically becomes itchy. Hives result from dilation of capillaries which allow fluid to flow out into the surrounding tissue which is the epidermis. They resolve when the body absorbs this fluid.{{citation needed|date=April 2020}} The border of a hive is described as polycyclic, or made up of many circles, and changes as fluid leaks out and then is absorbed.<ref>{{cite journal | author = Bailey Evan, Shaker Marcus | year = 2008 | title = An Update on Childhood Urticaria and Angioedema | url = | journal = Current Opinion in Pediatrics | volume = 20 | issue = 4| pages = 425–30 | doi=10.1097/mop.0b013e328305e262| pmid = 18622198 }}</ref> Pressing on a hive causes the skin to blanch distinguishing it from a bruise or papule. Hives can last for a few minutes or a few days, and vary from person to person. Also, a burning sensation occurs. A serious reaction is most likely to occur for patients where the hives occur with less than 3 minutes of exposure (during a cold test).<ref>{{cite journal |author1=Soter Nicholas A. |author2=Wasserman Stephen I. |author3=Austen K. Frank | year = 1976 | title = Cold Urticaria: Release into the Circulation of Histamine and Eosinophil Chemotactic Factor of Anaphylaxis during Cold Challenge | url = | journal = New England Journal of Medicine| volume = 294 | issue = 13| pages = 687–90 | doi=10.1056/nejm197603252941302|pmid=55969 }}</ref>
| | === Primary cold contact urticaria === |
| | This is the most common form and is triggered by direct contact with cold objects or environments. Exposure to cold air, water, ice, or even handling chilled items can provoke localized [[wheals]] or generalized [[urticarial rash]]. Onset typically occurs within 5–10 minutes of exposure. |
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| == Cause == | | === Secondary cold contact urticaria === |
| The hives are a [[histamine]] reaction in response to cold stimuli, including a drastic drop in temperature, cold air, and cold water. There are many causes for cold hives, most are [[idiopathic]] (meaning they have no known cause). Some rare conditions{{specify|date=July 2014}} can cause cold hives, and it can be useful to test for these conditions if the cold hives are in any way unusual.
| | This rare type is associated with underlying conditions such as [[cryoglobulinemia]] or [[cryofibrinogenemia]], where abnormal proteins precipitate at low temperatures. It may present alongside other symptoms such as [[Raynaud’s phenomenon]], [[purpura]], or [[vasculitis]]. |
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| Scientists from the USA [[National Institutes of Health]] have identified a genetic mutation in three unrelated families that causes a rare immune disorder characterized by excessive and impaired immune function: [[immune deficiency]], [[autoimmunity]], inflammatory skin disorders and cold-induced hives (cold urticaria).
| | === Reflex cold urticaria === |
| <blockquote>"The mutation discovered occurs in a gene for phospholipase C-gamma2 (PLCG2), an enzyme involved in the activation of immune cells. The investigators have named the condition PLCG2-associated antibody deficiency and immune dysregulation, or PLAID."<ref>[http://www.niaid.nih.gov/news/newsreleases/2012/Pages/PLAID.aspx News published on the National Institute of Allergy and Infectious Diseases (NIAID) website] (Jan. 11, 2012)</ref></blockquote>
| | This form involves widespread welting and rash triggered by a general drop in body temperature, such as immersion in cold water or exposure to a cold environment, without direct contact with cold substances. |
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| ==Risk factors== | | === Familial cold urticaria === |
| | Also known as '''familial cold autoinflammatory syndrome''' (FCAS), this is a rare inherited disorder that follows an [[autosomal dominant]] pattern. It is associated with mutations in the '''[[CIAS1]]''' gene (also known as [[NLRP3]]), which affects the [[innate immune system]]. Symptoms include [[recurrent fever]], [[arthralgia]], [[conjunctivitis]], and widespread urticaria after generalized exposure to cold. |
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| *Cold weather/Snow: Exposure to cold or cool air can quickly trigger a reaction; for example going down the "cold" aisle in a supermarket.
| | == Signs and Symptoms == |
| * Sweat: A reaction may even occur on a warm day when there is sweat on the skin, since the reaction is triggered by skin temperature, not core temperature. If there is a breeze it will rapidly cool the skin and create hives.
| | * Localized or generalized [[hives]] |
| * Cold/Cool IV Lines: While in the [[hospital]], inserting [[Intravenous therapy|IV]] lines that have been refrigerated or are cool into individuals who are [[allergic]] to [[cold]] [[temperature]] can/may result in pain within the limb the IV is placed and a line of [[hives]] may appear within a radius of 6-8 inches from the IV site in the pattern of a line going up the limb. | | * [[Swelling]] of exposed areas |
| * Swimming: Swimming can be especially dangerous as the rapid heart rate combined with the onset of hives can lead to [[hypotension]].
| | * [[Pruritus]] (itchiness) |
| * Air Conditioning: Entering a cool building during a summer day can result in an [[allergic]] reaction to exposed areas of skin, [[Nasal congestion|congestion]] from breathing the cool air and possibly feeling [[Fatigue (medical)|fatigued]]. | | * [[Headache]], [[fatigue]] |
| * Cold Foods/Drinks: Eating or drinking cold or cool substances such as ice cream or even iced tea may result in the individuals tongue and surrounding tissues [[Swelling (medical)|swelling]] and to suffocation. | | * [[Fever]] and [[chills]] (in familial cases) |
| * Cool/Cold Surfaces: Sitting on sidewalks which are cool, leaning on or grabbing a cold pole will result in hives forming on the area which had contact with the cool surfaces.
| | * [[Angioedema]] of the face, lips, or throat |
| * Restriction of Blood Flow: Typing or other activities which tense muscles and reduce blood flow can cool the body parts enough to cause itching and hives. | | * [[Anaphylaxis]] in severe cases (rare) |
| * Blood Flow: While putting hands or feet in hot water nails turn purple/white until the body gets used to the temperature.
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| == Diagnosis == | | == Diagnosis == |
| Diagnosis is typically obtained by an [[allergist]] or other licensed practitioner performing a cold test. During the cold test, a piece of ice is held against the forearm, typically for 3–4 minutes. A positive result is a specific looking mark of raised red hives. The hives may be the shape of the ice, or it may radiate from the contact area of the ice.<ref name=":0">{{cite journal |author1=Abajian M. |author2=Curto-Barredo L. |author3=Krause K. |author4=Santamaria E. |author5=Izquierdo I. |author6=Church M. |author7=Maurer M. |author8=Giménez-Arnau A. | year = 2016 | title = Rupatadine 20 Mg and 40 Mg Are Effective in Reducing the Symptoms of Chronic Cold Urticaria | url = http://edocs.fu-berlin.de/docs/servlets/MCRFileNodeServlet/FUDOCS_derivate_000000006072/4446.pdf| journal = Acta Dermato Venereologica Acta Derm Venerol | volume = 96 | issue = 1| pages = 56–59 | doi=10.2340/00015555-2150|pmid=26038847 }}</ref><blockquote>" However, while these techniques assist in diagnosis, they do not provide information about temperature and stimulation time thresholds at which patients will start to develop symptoms."<ref name=":0" /></blockquote>which is essential because it can establish disease severity and monitor the effectiveness of treatment.<ref name=":0" /> | | Diagnosis is typically clinical and confirmed by a **cold stimulation test**, which involves applying a cold object (such as an ice cube) to the skin for several minutes and observing for a reaction. Additional tests may include: |
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| == Treatment ==
| | * Blood tests to rule out secondary causes |
| The first-line therapy in ColdU, as recommended by [https://www.researchgate.net/profile/Martin_Church/publication/277782460_Rupatadine_20_mg_and_40_mg_are_Effective_in_Reducing_the_Symptoms_of_Chronic_Cold_Urticaria/links/55858db608ae7bc2f44bde5e.pdf EAACI/GA2 LEN/EDF/WAO guidelines], is symptomatic relief with second-generation H1- antihistamines. if standard doses are ineffective increasing up to 4-fold is recommended to control symptoms.<ref>{{cite journal |vauthors=Zuberbier T, Aberer W, Asero R, Bindslev-Jensen C, Brzoza Z, Canonica GW, etal | year = 2014 | title = The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update | pmid = 24785199 | journal = Allergy | volume = 69 | issue = 7| pages = 868–887 | doi=10.1111/all.12313}}</ref>
| | * [[Serum cryoglobulin]] or [[cryofibrinogen]] levels |
| | * Genetic testing for suspected familial cases |
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| The second-generation H1-antihistamine, [[rupatadine]], was found to significantly reduce the development of chronic cold urticaria symptom without an increase in adverse effects using 20 and 40 mg.<ref name=":0" />
| | == Complications == |
| | Cold urticaria can lead to serious and potentially life-threatening complications such as: |
| | * [[Pharyngeal edema]] from ingestion of cold drinks |
| | * [[Anaphylaxis]] following generalized cold exposure |
| | * [[Drowning]] due to sudden hypotension or unconsciousness while swimming |
| | * [[Hypothermia]] in prolonged cold environments |
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| Allergy medications containing [[antihistamines]] such as [[diphenhydramine]] ([[Benadryl]]), [[cetirizine]] (Zyrtec), [[Loratadine]] (Claritin), [[cyproheptadine]] (Periactin), and [[fexofenadine]] (Allegra) may be taken orally to prevent and relieve some of the hives (depending on the severity of the allergy).<ref name="pmid11409259">{{cite journal |author=Mahmoudi M |title=Cold-induced urticaria |journal=J Am Osteopath Assoc |volume=101 |issue=5 Suppl |pages=S1–4 |date=May 2001 |pmid=11409259 |doi= |url=http://www.jaoa.org/cgi/pmidlookup?view=long&pmid=11409259}}</ref> For those who have severe anaphylactic reactions, a prescribed medicine such as doxepin, which is taken daily, should help to prevent and/or lessen the likelihood of a reaction and thus, anaphylaxis. There are also topical antihistamine creams which are used to help relieve hives in other conditions, but there is not any documentation stating it will relieve hives induced by cold temperature.
| | == Treatment and Management == |
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| Cold hives can result in a potentially serious, or even fatal, systemic reaction ([[anaphylactic shock]]). People with cold [[hives]] may have to carry an injectable form of [[epinephrine]] (like [[Epi-pen]] or [[Twinject]]) for use in the event of a serious reaction.{{citation needed|date=August 2016}}
| | === General measures === |
| The best treatment for this allergy is avoiding exposure to [[cold]] [[temperature]].<ref>{{Cite web|url=http://www.mayoclinic.org/diseases-conditions/cold-urticaria/basics/definition/con-20034524|title=Cold urticaria - Mayo Clinic|website=www.mayoclinic.org|access-date=2016-05-04}}</ref>
| | * Avoid cold exposure and swimming in cold water |
| | * Wear warm clothing and cover exposed skin |
| | * Avoid consuming ice-cold foods or beverages |
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| Studies have found that [[Omalizumab]] (Xolair) may be an effective and safe treatment to cold urticaria for patient who do not sufficiently respond to standard treatments.<ref>{{cite journal| pmc=3551415 | pmid=23341807 | doi=10.1159/000346284 | volume=4 | issue=3 | title=Treatment of severe cold contact urticaria with omalizumab: case reports |vauthors=Brodská P, Schmid-Grendelmeier P| journal=Case Rep Dermatol | pages=275–80| year=2012 }}</ref>
| | === Medications === |
| | * [[Second-generation antihistamines]] (e.g., [[cetirizine]], [[loratadine]]) |
| | * [[First-generation antihistamines]] (e.g., [[hydroxyzine]]) for more sedative effect |
| | * [[Montelukast]] or other leukotriene receptor antagonists |
| | * [[Omalizumab]], a monoclonal antibody, in severe or refractory cases |
| | * [[Epinephrine]] auto-injector (e.g., EpiPen) for emergency use in patients at risk of anaphylaxis |
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| [[Ebastine]] has been proposed as an approach to prevent acquired cold urticaria.<ref name="pmid17900265">{{cite journal |vauthors=Magerl M, Schmolke J, Siebenhaar F, Zuberbier T, Metz M, Maurer M |title=Acquired cold urticaria symptoms can be safely prevented by ebastine |journal=Allergy |volume=62 |issue=12 |pages=1465–8 |date=December 2007 |pmid=17900265 |doi=10.1111/j.1398-9995.2007.01500.x }}</ref>
| | == Prognosis == |
| | The course of cold urticaria varies. In many cases, symptoms gradually diminish or resolve over several years. However, some patients may experience chronic symptoms requiring long-term management. Familial cases may persist for life and require more aggressive intervention. |
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| ==See also== | | == Epidemiology == |
| * [[Amyloidosis]]
| | Cold urticaria is a rare condition, more common in younger individuals and those with a history of other [[atopic disorders]]. It affects both sexes but may be slightly more prevalent in females. |
| * [[Cholinergic urticaria]], a similar hives reaction in response to heat
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| * [[Aquagenic urticaria]]
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| * [[Diascopy]]
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| * [[Erythema]]
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| * [[Goose bumps]], an unrelated, normal response to cold temperatures
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| * [[List of cutaneous conditions]]
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| * [[Skin lesion]]
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| * [[Plaid syndrome]]
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| ==References== | | == See also == |
| {{Reflist}}
| | * [[Urticaria]] |
| | * [[Angioedema]] |
| | * [[Anaphylaxis]] |
| | * [[Mast cell]] |
| | * [[Histamine]] |
| | * [[Cryoglobulinemia]] |
| | * [[Autoinflammatory syndrome]] |
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| == External links == | | == External links == |
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| }} | | }} |
| {{Urticaria and erythema}} | | {{Urticaria and erythema}} |
| | | {{Dermatology}} |
| | {{Immune system disorders}} |
| [[Category:Urticaria and angioedema]] | | [[Category:Urticaria and angioedema]] |
| {{dictionary-stub1}}
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